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Year : 2010  |  Volume : 27  |  Issue : 3  |  Page : 190 Table of Contents   

Chilaiditi sign

Consultant Endoscopic and laparoscopic surgeon, Ronak endo-laparoscopy and general surgical hospital, Patan-384265, Gujarat, India

Date of Web Publication10-Aug-2010

Correspondence Address:
Vipul D Yagnik
Consultant Endoscopic and laparoscopic surgeon, Ronak endo-laparoscopy and general surgical hospital, Patan-384265, Gujarat
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-2113.68311

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How to cite this article:
Yagnik VD. Chilaiditi sign. Lung India 2010;27:190

How to cite this URL:
Yagnik VD. Chilaiditi sign. Lung India [serial online] 2010 [cited 2021 Apr 14];27:190. Available from: https://www.lungindia.com/text.asp?2010/27/3/190/68311


A 63-year-old male came for routine health check up. He was asymptomatic and had no significant past surgical or medical history. All routine blood investigations, pulmonary function test, ECG, 2D-echocardiography were normal. On examination, abdomen was soft and did not reveal any sign of peritonitis. His vitals were normal. Chest X-ray (PA View) revealed air under dome of right diaphragm [Figure 1].
Figure 1: Chilaiditi sign

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Transposition of loop of colon in between diaphragm and liver is known as chilaiditi sign. [1] Incidence is around 0.1-1%. Most patients are asymptomatic. [1] Shortness of breath is a common manifestation of this condition. Sometimes, other symptoms like pain in abdomen, nausea and distention can be the presenting symptoms. Symptomatic presentation with chilaiditi sign is termed as chilaiditi syndrome. It was first described by a Greek radiologist Demetrius Chilaiditi in 1910. Chilaiditi sign may be seen in cirrhosis and COPD. Redundant mobile colon due to laxity of suspensory ligament of large intestine or liver may be the contributory cause of chilaiditi sign. Other conditions like colonic volvulus [2],[3] and few colonic malignancies may be associated with chilaiditi syndrome. Diagnosis is usually made by X-ray; CT scan will help in confirmation of diagnosis in case of suspicion. Most patients respond to medical management, and surgery is reserved for those who do not respond to usual conservative line of management. This condition is important for chest physicians because few patients with breathlessness may present with this type of X-ray picture and respiratory pathology is not needed in such cases. All chest physicians should be aware that shortness of breath is not always due to problem in the chest.

   References Top

1.Sanyal K, Sabanathan K. Air below the right diaphragm: Chilaiditi sign. Emerg Med J 2008;25:300.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]  
2.Loke KL, Chan CS. Case report: Transverse colon volvulus: Unusual appearance on barium enema and review of the literature. Clin Radiol 1995;50:342-4.  Back to cited text no. 2  [PUBMED]    
3.Eisenstat TE, Raneri AJ, Mason GR. Volvulus of the transverse colon. Am J Surg 1977;134:396-9.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]  


  [Figure 1]

This article has been cited by
1 Subphrenic free air | [Opacité aérique sous-diaphragmatique droite]
Daldoul, S., Moussi, A., Triki, W., Bourguiba, B., Zaouche, A.
Colon and Rectum. 2011; 5(2): 101-103
2 Opacité aérique sous-diaphragmatique droite
S. Daldoul,A. Moussi,W. Triki,B. Bourguiba,A. Zaouche
Côlon & Rectum. 2011; 5(2): 101
[Pubmed] | [DOI]


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